ACI Program from MACRA to Overhaul Meaningful Use

April 29th, 2016 - By Kevin V. Nguyen

We’ve recently looked at the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its overhaul of Medicare, specifically with the revamping of quality reporting systems (Meaningful Use and PQRS). The Centers for Medicare & Medicaid Services (CMS) has just released new important information on MACRA that directly affects how providers use electronic health records (EHRs) and Meaningful Use.

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The CMS has updated one of the key components of MACRA: the Merit-Based Incentive Payment System (MIPS). As we went through in our MACRA breakdown, MIPS takes parts of the old quality reporting systems such as Meaningful Use (MU) and the Physician Quality Reporting System (PQRS) and creates a new comprehensive system.

The updated MIPS incorporates a program called Advancing Care Information (ACI) to replace Meaningful Use. The ACI promises to be “more patient-centric, practice-driven and focused on connectivity”, and specifically focuses on revamping the Meaningful Use’s interaction with EHRs.

MIPS Composite Score

ACI Replaces Meaningful Use in MIPS

Advancing Care Information to Overhaul MU, Why?

The CMS came to the conclusion that many providers had already reached: Meaningful Use was near-impossible to accomplish because of the extensive requirements, and how fast providers had to transition to an EHR. ACI was created to overhaul Meaningful Use into a system provider can manage. The inclusion of the ACI is focused on three goals:

  • Improved interoperability and the ability of physicians and patients to easily move and receive information from other physician’s systems;
  • Increased flexibility in the Meaningful Use program; and
  • User-friendly technology designed around how a physician works and interacts with patients.

The ACI is focused on becoming a “more flexible, outcome-oriented and less burdensome proposal” than Meaningful Use.

Details of the ACI

The ACI differs from Meaningful Use in various ways; the CMS highlights the key operational differences:

  • Allow physicians and other clinicians to select measures that reflect how technology best suits their day-to-day practice
  • Simplify the process for achievement and provide multiple paths for success
  • Align with the Office of the National Coordinator for Health Information Technology’s 2015 Edition Health IT Certification Criteria
  • Emphasize interoperability, information exchange, and security measures and require patients to access their health information through APIs
  • Simplify reporting by no longer requiring all-or-nothing EHR measurement or quality reporting
  • Reduce the number of measures to an all-time low of 11 measures, down from 18 measures, and no longer require reporting on the Clinical Decision Support and the Computerized Provider Order Entry measures
  • Exempt certain physicians from reporting when EHR technology is less applicable to their practice and allow physicians to report as a group

It’s important to note that Advancing Care Information would affect only Medicare payments to physician offices, not Medicare hospitals or Medicaid programs.

Deadlines & Final Thoughts

The implementation of ACI is another step towards finding an interoperable solution for providers and EHRs. It revamps a system which was largely ineffective and cumbersome for most providers.

This proposal, if finalized, would replace the current Meaningful Use program and reporting would begin on January 1, 2017.

The CMS website has comprehensive information on the Quality Payment Program (MACRA) and the ACI.

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